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Women's decision-making in prenatal screening
P Santalahti1, E Hemminki, A M Latikka
1National Research and Development Centre for Welfare and Health, Health Services Research Unit, Helsinki, Finland.
Social Science & Medicine (1982)
|May 14, 1998
Summary
Many women undergoing prenatal serum screening for Down's syndrome do not actively decide to participate, leading to ethical concerns. This highlights the need for careful consideration when introducing new healthcare practices.
Area of Science:
- Maternal-Fetal Medicine
- Reproductive Health Ethics
- Medical Sociology
Background:
- Prenatal serum screening involves multiple complex decisions for expectant mothers.
- These decisions include initial participation, diagnostic testing, and actions following abnormality detection.
Purpose of the Study:
- To explore how women in an unselected population describe their decision-making processes during serum screening.
- To identify potential ethical issues arising from the decision-making context of prenatal screening.
Main Methods:
- Semistructured interviews were conducted with women who received positive serum screening results and matched controls.
- Participants were interviewed between 29-37 weeks of gestation in two Finnish towns.
Main Results:
- Half of the women viewed serum screening participation as routine, with only a quarter actively deciding to participate.
- Decision-making regarding diagnostic tests and intentions for abortion varied significantly among women.
- A notable percentage (23%) considered diagnostic testing a self-evident act, not an active choice.
Conclusions:
- Prenatal screening, despite being voluntary, is not always based on active decision-making, creating ethical challenges.
- The ethical implications of non-active decision-making in prenatal screening require attention from healthcare developers and policymakers.